Healthcare Provider Details

I. General information

NPI: 1508680992
Provider Name (Legal Business Name): LENLAK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 NEW DORP LN
STATEN ISLAND NY
10306-3005
US

IV. Provider business mailing address

325 NEW DORP LN
STATEN ISLAND NY
10306-3005
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-2400
  • Fax: 718-351-5400
Mailing address:
  • Phone: 718-351-2400
  • Fax: 718-351-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: OLENA KURUS
Title or Position: PRESIDENT
Credential:
Phone: 718-351-2400